Provider Demographics
NPI:1962214007
Name:SAWADA, MICHAELANGELO SEIJI PARCE (PSS/QMHA-R)
Entity type:Individual
Prefix:
First Name:MICHAELANGELO SEIJI
Middle Name:PARCE
Last Name:SAWADA
Suffix:
Gender:M
Credentials:PSS/QMHA-R
Other - Prefix:
Other - First Name:SEIJI
Other - Middle Name:PARCE
Other - Last Name:SAWADA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSS/QMHA-R
Mailing Address - Street 1:211 SE CARUTHERS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4502
Mailing Address - Country:US
Mailing Address - Phone:503-224-1044
Mailing Address - Fax:971-260-0355
Practice Address - Street 1:703 NE HANCOCK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3955
Practice Address - Country:US
Practice Address - Phone:503-230-9875
Practice Address - Fax:503-331-3441
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR112974175T00000X
OR24-QMHA-R-5520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health